Project Summary The present application seeks to renew our funded R25 ?Combined Psychiatry Residency and PhD Training at Mount Sinai?. We aim to allow our current trainees to complete their 7-year program and to show how maximizing the time for research during psychiatry residency, combined with half-time NIMH-supported research, can yield sufficient time over 7 years for trainees to complete their PhDs. We also seek support for three new trainees to enter the program. The motivation for this novel model for PhD training of MDs emerged from the belief that psychiatry is a fertile medical specialty for translational research and that those with both an MD and a PhD have the opportunity to bridge the gap between neuroscience and clinical psychiatry. We recognized that only a small number of MD/PhD graduates (5-6%) choose to specialize in psychiatry across the country and not all of those choosing psychiatry continue in research careers after residency. This may be in part because the established method of combined MD/PhD training is inefficient, requiring years of clinical training between completing the PhD and graduating from clinical training. Graduates experience a decline in research skills and often need to retrain after residency. Thus few young MD/PhDs apply for K or R01 Awards. Mount Sinai continues to be the ideal place for this novel program because of the strength of our Departments of Psychiatry, Neuroscience and Genetics/Genomics. Indeed, our Department of Psychiatry is ranked #6 in the country in NIH funding (#1 in funding by funded investigator), the Department of Neuroscience is ranked #2 and the Department of Genetics is ranked #4 (Blue Ridge Institute for Medical Research). Our exponential success in research accomplishments and funding is the result of a focused institutional effort to support translational research. Our initial 5-year R25 grant was funded 4 years ago to support the training of residents in a 7-year program combining psychiatric residency with PhD training in neuroscience or genetics. We have successfully recruited one outstanding applicant per year as planned and have thereby demonstrated that we can harness a combination of GME funds (a resident pay line) to support clinical training (year 1 and 50% of years 2-7) with the R25 funds to support research time (50% of years 2-7). We are presently starting year 5 of the grant; thus, inevitably, our trainees are still in the midst of their 7-year training (See Participants and Preliminary Data). Ours is the only program in the country offering PhD training within a psychiatry residency and our renewal application aims to permit us to continue this unique program and to show the success of our trainees as they graduate. Notably, other programs at Mount Sinai (Neurology, Neurosurgery, Medicine and Pediatrics) are using our program to model their own Residency or Fellowship/PhD programs as part of the newly created Mount Sinai Physician Scholars Program.